Análise da densidade endotelial por faixa etária dos doadores de córnea em um banco de olhos no Estado do Paraná, Brasil / Endothelial density analysis by age group of corneal donors in an eye bank in Paraná State, Brazil

Resumo Objetivo: Analisar a densidade endotelial das córneas doadas para transplante nas diferentes faixas etárias. Métodos: O estudo avaliou 244 córneas de 122 doadores de ambos os sexos no Banco de Olhos de Cascavel-PR a partir da análise de prontuários médicos contendo a microscopia especular dos doadores. Resultados: A maioria dos doadores de córnea era do sexo masculino (67,2%). A idade média dos doadores foi 53,8 anos com variações entre 5 e 70 anos. A faixa etária dos 61-70 anos com o maior número de doações, correspondendo a quase 41% e a densidade média endotelial foi de 2645 células/mm² (variando de 1897 a 4201 células/mm²). Na primeira década de vida, a densidade endotelial média foi 2923 células/mm²; na segunda década 2757 células/mm²; na terceira 2846 células/mm²; na quarta 2627 células/mm²; na quinta década, 2830 células/mm²; na sexta 2605 células/mm² e na sétima década de vida 2570 células/mm². Conclusão: Este estudo demonstrou que a densidade endotelial média das córneas doadas para transplante na primeira década de vida (2923 células/mm²) quando comparada isoladamente à sétima década (2570 células/mm²) teve redução. Já na avaliação da segunda até a sexta década não houve um padrão, ora havendo acréscimo, ora decréscimo da densidade endotelial média.

Abstract Objective: To analyze the endothelial density of corneas donated for transplant in different age groups. Methods: The study evaluated 244 corneas from 122 male and female donors in Cascavel Eye Bank -PR from the analysis of medical records containing specular microscopy of the donors. Results: Most corneal donors were male (67.2%). The average donors age was 53.8 years, ranging from 5 to 70 years. The age group of 61 -70 years with the largest number of donations, corresponding to almost 41% and the average endothelial density was 2645 cells / mm² (ranging from 1897 to 4201 cells / mm²). In the first decade of life, mean endothelial density was 2923 cells mm²; in the second decade 2757 cells / mm²; in the third 2846 cells / mm²; in the fourth 2627 cells / mm²; in the fifth decade, 2830 cells / mm²; on the sixth 2605 cells / mm² and on the seventh decade of life 2570 cells / mm². Conclusion: This study demonstrated that the mean endothelial density of corneas donated for transplant of the first decade of life (2923 cells / mm²) when compared to the seventh decade alone (2570 cells / mm²) was reduced. In the evaluation from the second to the sixth decade, there was no pattern, sometimes there was an increase, sometimes a decrease in the average endothelial density.

Características de la córnea donante mediante microscopia endotelial / Donor cornea characterization by endothelial microscopy

RESUMEN Objetivo: Determinar las características del endotelio corneal mediante microscopia endotelial. Métodos: Se realizó un estudio descriptivo y retrospectivo en córneas donantes del banco de ojos del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" en el período de enero a junio del año 2019. La muestra estuvo conformada por 224 córneas donantes. Las variables del estudio fueron: edad, cirugías previas, gerontoxón, pterigion, defectos epiteliales, infiltrado corneal, opacidad corneal, edema, pigmentos endoteliales, guttas, desprendimiento de la Descemet, densidad celular, hexagonalidad y polimegatismo. Resultados: El gerontoxon fue el hallazgo más frecuente (56,69 por ciento); la densidad celular media fue de 2 501 cel/mm2; el coeficiente de variación medio fue 43,32 y la hexagonalidad media 50,02. La densidad celular endotelial entre 2 000 y 2 500 cel/mm2 fue más frecuente entre 60 y 79 años de edad (76,72 por ciento), mientras que entre 20 y 29 años todas las córneas donantes presentaron una densidad endotelial mayor de 2 500 cel/mm2. Conclusiones: En el examen biomicroscópico de la córnea donante fue más frecuente el gerontoxon. Por microscopia endotelial la mayoría de las córneas fueron aptas para trasplante corneal. Un endotelio corneal con densidad celular mayor de 2 500 cel/mm2 no es exclusivo de córneas con menos de 60 años de edad(AU)

ABSTRACT Objective: Determine the characteristics of the corneal endothelium by endothelial microscopy. Methods: A retrospective descriptive study was conducted of donor corneas from the eye bank of Ramón Pando Ferrer Cuban Institute of Ophthalmology from January to June 2019. The sample was 224 donor corneas. The variables analyzed were age, previous surgery, gerontoxon, pterygium, epithelial defects, corneal infiltrate, corneal opacity, edema, endothelial pigments, guttae, Descemet's membrane detachment, cell density, hexagonality and polymegethism. Results: Gerontoxon was the most common finding (56.69 percent), mean cell density was 2 501 cell/mm2, mean variation coefficient was 43.32 and mean hexagonality was 50.02. Endothelial cell density from 2 000 to 2 500 cell/mm2 was more common in the 60-79 years age group (76.72 percent), whereas in the 20-29 years age group all the donor corneas had an endothelial density above 2 500 cell/mm2. Conclusions: Gerontoxon was the most common finding in the biomicroscopic examination of the cornea. Endothelial microscopy found that most corneas were suitable for corneal transplantation. A corneal endothelium with a cell density above 2 500 cell/mm2 is not exclusive of corneas under 60 years of age(AU)

The Effect of Healon(R) and Metrol(R) on Cornea and Intraocular Pressure in Extracapsular Cataract Extraction with Posterior Chamber Lens Implantation

The aim of this study is to evaluate the effect of viscoelastic substance on corneal thickness, corneal endothelium and intraocular pressure by measuring corneal thickness, corneal endothelial cell density and intraocular pressure in extracapsular cataract extraction with posterior chamber lens implantation. The study comprised of 50 patients, divided into two groups: extracapsular cataract extraction with posterior chamber lens implantation using Healon(R) or 2% methylcellulose(Metrol(R)). The txtracapsular cataract extraction was done by irrigation and aspiration technique and the posterior chamber lens was implanted into posterior chamber. The corneal thickness and endothelial cell density were measured preoperatively and at 6 weeks of postoperative period: intraocular pressure was measured preoperatively and at 24 hours of postoperative preiod. The results were as follows: 1. The preoperative corneal thickness, endothelial cell density and intraocular pressure were 499 +/- 34 micrometer, 2523 +/- 388 cells/mm2 and 15.9 +/- 2.4mmHg in average respectively. 2. The postoperative corneal thickness with Healon(R) was 501 +/- 42 micrometer, and with Metrol(R) was 491 +/- 28 micrometer. There was no significant difference between Healon(R) used and Metrol(R) used group(p<0.05). 3. The loss of endothelial cell with Healon(R) was 10.7%, and with Metrol(R) was 17.1%. The endothelial cell loss was lower in Healon(R) used group than that of Metrol(R) group. 4. The intraocular pressure with Healon(R) was 14.6 +/- 3.9mmHg, and with Metrol(R) was 12.3 +/- 4.4mmHg. There was no significant difference between Healon(R)-used and Metrol(R)-used group(p<0.05).